MESOTHERAPY

By Lembaga Estetik Medik

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History
• 1952: dr. Michel Pistor used Procaine
injections behind the ear for hearing
loss.
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History
• 1958: The first press’ publication about
Pistor’s experiments and the used of
term “Mesotherapy”
• 1964: SFM (Societe Francaise
Mesotherapy)
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The first Mesotherapy

International congress

• 1982: The International

Society of Mesotherapy

• 1987: Mesotherapy as a
part of traditional
medicine in French
Academy of Medicine
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History
• 2004: Mesotherapy’s booming in USA
• 2005: Mesotherapy in Indonesia
• Over 25,000 physicians worldwide today use
mesotherapy .
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MESOTHERAPY
• What is Mesotherapy?
Multiple injections of “microdoses” of active medications
into the epidermis or into the dermis (embryologically
derived from the ‘mesoderm’) of the skin, at relatively
infrequent but regular intervals.
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• Skin test
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• Dr. Pistor defined Mesotherapy as …..

…”To bring the right product (medicine),

in the right amount,
to the right place”…..
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Why Mesotherapy?
‘Cause it Works!

Characteristics:
• Simple technique
• Locoregional
• Minimum secondary effects
• Minimum doses
• Economics
• Very Effective
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Advantages
• Good for mild – moderate aging (figures 1.6 and 1.7)
• Easy to perform
• Low pain
• No Necessity for a skin test
• Limited side effect
• No downtime or a recovery time
• Can be performed on every skin phototype
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General indications for Mesotherapy

• Sports injuries arthropathy muscle tear, stress factures, tendom

strain,meriscal tears, plantar fascitis, tendon denegeration.
• Chronic painful condition : bone spurs, carpal tunnel syndrome,
chronic low back pain contractures, fybromyalgia , frozen shoulder ,
ulnar neuropathy,degenerative arthritis, gout herniated disc pain,
neuralgia.
• General medical conditions : allergies, alpecia, asthma,auto
immune disease, bronchitis coronary insufficiency, vertigo
• Skin Conditions acne, cellulite, contusiones, eczema & keloids,
male/ female hair loss, obesity, scar, telangiectasias, vitiligo,
wrinkles, hyperpigemntation
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Indications NON-AESTHETIC
 Dermatology
AESTHETIC  Gastroenterology
 Neurology
 Mesoglow  Gynecology
 Mesolift  Sport medicine
 Mesolipo/sculpting  Ear ,nose, & throat
 Urology
 Mesomelasma
 Vascular disease
 Mesocellulite  Traumatology &
 Mesostretchmark Rheumatology
 Others: presbyopia, mouth
 Mesoalopecia sores,
 Mesobotox etc
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Areas of aplication
• Face (cheeks, chin, forehead)
• Neck
• Low neckline
• Back of hands
• Abdomen
• Arm and legs (inner surface)

Contra Indications

 Allergy (especially to the injection ingridients )

 History of hyperthropic scars
 Bleeding abnormallities and or oral anticoagulant therapy
 Pregnancy /breast feeding
 Autoimmune disordes (lupus, scloderma)
 Epilepsy
 Diabetes
 Herpes simplex virus type 1 (HSV-1) infections
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• Bacterial infections
• Inflammatory skin disordes (acute phase)

Note : HSV-1 infection are acontraindications if present in

the active phase in order to avoid reccurences in those
patients suffering from cold sores, oral prophylaxis with
valacyclovir is mandatory (500mg twice daily for 5 days)
A single dose of famciclovir (1500mg) can also be used
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Technique
• Manual  mesotherapy needles

• Mesogun

• Dermaroller
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Injection Rules:

…The right needle…

… & the right drugs…
…for the right site….
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Frequency
• 1x/ week for 1 month (4x)
• 1x/ 2weeks for 1 month
• 1x/ month every 3 months

Or
1 session / week during 2 months
1 session / month
Can vary according to skin condition, lifestyle,
Reaction to thetreatment, desire for quiker result
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Mesotherapy Cocktail
The cocktail is made of revitalizing subtances in a sterile biological solution supplied in a 5ml bottle
(NTCF 13.5)

Vitamins
• It is a easy understand that there is no problem because these vitamins are
injected directly into the dermis atrophy.
• The vitamin b complex – vitamin B1 (thiamine),B2 (riboplavin),B3 (Niacin), B5
(pantothenate), B6 (pyridoxine), B9 (folic acid) and B12 (cyanocobalamin) are
coenzymes in several metabolic processes that have to scavenges free
radicals
• Vitamin C stimulates collagen synthetis and inhibits melanin (acting together
with vitamin E )
• Vitamin E is a strong antioxidant because of its anti free radical activity
• Vitamin K has an effect on the microcirculation
• Also important are vitamins D, H (biotin) b10 and I (innositol)
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Amino Acids

The cocktail contains 24 amino acids, which are stable water

soluble and part of the structure of proteins . They build Polypeptides
Which from the matrix of the cellular architecture or repair the protein
the structure of tissue that has been damaged by photoaging, smoking
or other causes.

Minerals
Sodium, potassium, calcium and magnesium act as catalysts of
numerous cell function.
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Hialuronic Acid (HA)

• 1 gr HA can binded 6 L of water
• The higher percentage of HA in product (mg of HA beads
per ml ), the higher capacity will be to retain water
• The greater molekul mass of HA ,the slower degradation
in the skin, so its hidration capasity is higher.
• Choose high molekull mass
• Shorter period than HA filler
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HA in meso
• Fluid
• Uncrosslink
• Available in fragmen, together with Amino Acid, enzim, etc
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Product used for improving the circulation and vascular

system
Benzopirone
 This has powerful lymphotrophic action
 It can sgnificantly reduce of vascular origin
 It is mainly used to improve the absorption of other drugs especially into the
lymphatic system.

Buflomedil
 This works directly as a vasodilator it is a phospodiesterase enzyme inhibitor
stimulates cyclic adenosine monophospate and biological vasodilators

Ginko Biloba
 Ginko flavonoid directly dilate the smalllest segment of the circulatory system the
microcappilaries which increase both blood circuation
and oxygen levels in the brains as well as in criticals organ.
• Ginko is highly important antioxidant shown have a special affinity for scavenging the
superoxide radicals
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Pentoxifylline
 This increases erythrocyte flexibility and decreases blood viscosity
 A vasodilator it improves microcirculation and tissue oxygnation

Rutin
 This has antioxidant anti inflammatory, anti carcinogenic , anthitrombhotic
,cytoprotective and vasoprotective activity

Melilotus
 This has anti imflammatory and anti edematous activity
 It is used in preventive treatment of varicose veins and natural them boplebitis
 It increases capilary and venous tone and causes vasodilation and lymphatic
drainage.
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For Mesosculpt

Phospatidylcholine
 This antioxidant is derived from natural soy lecithin
 It alters the metabolism of fatty subtances such as cholestrol and tryglycerides in the body
 It is an excellent “fat burner”

L Carnitine
 This is required for fatty acids to be delivered into cells where the fat can be burned as a source
of fuel
 Dist and exercise along with L Carnitine will maximaze fat removal

Caffeine
 This alkaloid increase the blood flow and stimulates fat cells where the fat cells to release fat into
the blood stream to be burned by the body metabolism
 It acts to drain the fat cells
 It thightens and tones the skin
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Aminophyline
 This stimulates the release of fat into the bloodstream
 Its effectiveness is similar to that of caffeine
 However it is less stable and must be kept in a cool place and used quickly
 It allows beta receptors to burn the fat more effeciently

Yohimbine (rombina)
 This is an alkaloid found in the inner bark of a tree that grows in south afrrica
(corynanthe yohimbe)
 Its is excellent for targetting localized fat
 It its an alpha-2 antagonist enhacing beta receptor activation
 It has a lipolytic effect primarily for lower body fat in females, but can be used
abdominally and in males

Triiodothyroacetic acid
 This is an excellent fat burner
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DMAE (dimethylamine ethanol)

 This is commonly used in topical formulas for anti aging
 It acts at the neuromuscular junction as a precursor of acetylcholine, the neotransmitter responsible
for a muscular contraction increasing the overall tone of the skin
Thymomodulin
 This is extracted from the
 It is an imrs unmodulator that increases T lympocytes , CO3,CD4, CD8 cells and neutrophic
functions and regulates levels of immunoglobulins A and G
 It is an effective in erasing smokers lines and cleansing the skin of harmful polutants such as smoke
 It helps reverse photoaging

Alpha-lipoic acid
 This is a powerfull anti oxidant
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Asian Centella
 This helps in strengthening the cappilaries and veins and in so doing assist with better blood
circulation
 Its stops the formation of fibers that trap fat cells in cellulite and improves the flexibility of the
coonective tissue
 It is in used repigmenting stretchmarks it can cause allergic reaction and hyperpigmentation (the
same property that makes it effective in treating stretchmarks)

Glycolid Acid
 This is the most commonly used AHA
 It works by stimulating new growth of skin and collagen and by decreasing the bonds that hold dead
skin cells to the surface

Hyaluronic Acid
 This Natural subtances is found in all living organism
 It is indicated for the treatment of aged and dehydrated skin
 It has a high affirity for water
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 A nonstabilized from is used in mesotherapy

 It is used for tissue hydration, lubrication, and smoothness and for softening and decreassing
wrinkles of the face, neck and scalp

Piruvato Sodico
 This is involved in the synthestis of amino acids
 It enchances weight loss
 It stimulates collagen synthetis
 Its act snergystically with L Carnitine

Vitamin C
 This players a role in collagen formation
 It is a key immune systems nutrient
 It has potent Activity againts free radicals

Aminomethylsilenetriol
 This is Lypolitic
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For Mesoglow
• Gluthatione a powerful antioxidant
• SOD (superoxide dismutase) prevents melasma
• Vitamin C an antioxidant
• Argireline : helps wrinkle reduction
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Single Component Injection Versus Cocktails

Recently the issue has been raised that injecting a product made up
of a single component may be than better than injecting a cocktail
side effect resulting from interaction between different components
are reduced and active principles, injected alone are more effective.
However, should we deprive patients of the proven efficiacy the
cocktail? This started to show its efficiacy many years ago and
especially for those who want to used crosslinked HA,it is very
important to diute it, otherwise the interdermal injection sites may
be seen for weeks as papules on the skin
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Injection Techniques

Papule Nappage Point by Point

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Mesotherapy injection techniques

• From the surface to the deeper layers:

Injection technique Depth Abbreviation

1. Epidermal < 1 mmIED
2. Papule 1 mm N/A
3. Nappage 2-4 mm IDP
4. Point by point 4 mm PPP
5. Mesoperfusion > 4mm N/A
6. Mixed variable N/A
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Abbreviations used for injection techniques

Abbreviation Technique
• I.E.D. Intra Epi Dermal
• I.D.S. Intra Dermal Superficial
• I.D.P. Intra Dermal Profound
• I.H.D. Intra Hypo Dermal
• P.P.P. Point by point
• S.C. Subcutaneous
• Mixed The use of more than one
technique within one
session at one body region
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EPIDERMAL

• Applied onto or into the epidermis, no bleeding,

simple, painless, allows to expand areas.

• Technique: manual or mesogun

• Needle: special needle for mesotherapy

30 G 4mm
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Manual intra epidermal

Manual epidermal
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Parkinson’s hand

Parkinson hands
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Criss-cross technique

Criss cross technique

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PAPULE : IDS
• Definition: Injection applied
where epidermis meets the
dermis. Depth 1-2 mm, the
epidermis usually lifted from the
basal layer
• Bevel upwards
• Material : needle 27-30 G , 4mm
• Indication: wrinkles, mesobotox
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Papule technique

Papule technique
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Nappage
• Definition:
2-4 injections per second, every 2-4 mm, under
continuous visual control, 30-60 degrees, needle
penetration 2-4mm.

• Material: needle 30 G 4mm

• 0,01-0,02 cc per injection.

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Manual nappage IDS

Manual nappage
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Point by point
• Definition: precise and single injection into the deep
dermis

• Material: needle 30 G ,4 mm - 6 mm

• Indication : stage 3-4 cellulite, fibro-sclerous cellulite

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PPP technique on belly

PPP technique
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Injection Application Technique

multipuncture coating
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Injection application Techniques

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Mesotherapy Needle Roller(MTS)

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How it works?
Step One  The Microneedles of the
dermaroller penetrate the epidermis and
dermis layer of skin
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Step 2  The derma roller needles will leave

micro channels into the skin. These channels
improve the penetration of therapeutic active
ingredients such as mesotherapy products.
These channels closed within hour. The
epidermis remains intact
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Step 3  The post traumatic response of the

skin is to produce collagen and elastin. These
bulk up the thickness, creating great looking,
firmer and healthier looking skin.
Indication
• Cellulite treatment
• Skin rejuvenation : improving skin thickness & tone,
reducing wrinkle
• Reduce pigmentation
• Scars : post acne, stretch marks
• Hair Loss
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Contraindication

• Disease of healing
• History of keloid
• Uncontrolled diabetes
• Pregnancy / Nursing
Transcellular Route
Normal creaming With derma roller

No more than 0,3% can penetrate up to 40 times can be infiltrated

the skin surface through the stratum corneum

Confocal laser pictures taken by the Uiversity of Marburg/Germany

Procedure
• Cleaning the area of treatment
• Once ready to roll, apply a numbing agent.
• Rolling the Dermaroller in different directions, with slight
pressure
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• Apply an antibacterial cream to protect from any

possible infection if needed

• Applying a vitamin rich moisturizer after use

• Slight reddening of the area may occur after

treatment. This will fade quickly but dependant on
the method, it may last for up to 24 hours. Staying
out of the sun for this period or using a sunblock
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• Short healing period

• Ideally,1 device per session
• Less expensive than big investment machinary
• Can be safely combined with other treatment. Ex.
Chemical peeling
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This patients lost 7 inches from her abdomen, back, &

hips undergoing 10 treatments.
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Mesolipo
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Meso Non Needle-Electroporesis

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The article would present two cases of the

facial treatment. The first we would show the
response to injections Lipolysis only and the
second case would show a result of
combined treatment with Lipolysis (LY),
Clostridium Botulinum Toxin (BT) and
Injectable Dermatological Filler (FR).
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In general it can be said that facial treatments, performed

according to the protocol of Network Lypolisis are very
successful and moistly only one or two sessions are
needed.
Following parts of the face can be treated with lippodissolve
injections:

• Glabellar fold
• Nasolabial fold
• Cheeks
• Jowls
• Double chin
• Neck
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Recently the issue has been raised that injecting a product

made up of a single component may be than better than
injecting a cocktail side effect resulting from interaction
between different components are reduced and active
principles, injected alone are more effective. However,
should we deprive patients of the proven efficiacy the
cocktail? This started to show its efficiacy many years ago
and especially for those who want to used crosslinked HA,it
is very important to diute it, otherwise the interdermal
injection sites may be seen for weeks as papules on the
skin
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To avoid hematoma / bleeding

• Do not perform mesotherapy during a patient’s menstrual period.

• Do no let the patient take aspirin or a nonsteridal anti inflammatory drug (NSAID) for a
few day after the procedure.
• Inject the product slowly, to avoid the high preasure breaking vessel walls.
• Apply antibiotic cream after each session.

To avoid pain, in sensitive patient :

• Pinch or strech the skin during the injections.

• Perform the injections precisely
• Change the needle several time during each treatment.
• Choose products containing lidocaine or apply emla cream 1 hour before treatment.
• Talk the with patient a lot during the session.
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The frequency of treatment varies, depending on :

• Type of medicine to be used
• Age of patient
• Degree of sun exposure
• Race of patient
• Hereditary of factors

The frequency schedules are :

• Every 2 weeks for 6-8 visits

• Every week 7 – 10 visits
• Every month, with no time a limits

The expected outcome are :

• Generally plumper and clearer skin

• Fewer wrinkles
• Complexion events out in color
• Skin becomes radiant & glowing, looking younger, rested & revitalized
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THANK YOU